DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Self, Marissa Kay	DOIID	1005793	NAIC NPN	17108119

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/21/2018		9/30/2025
Active	Non Resident	Agent	Property	8/21/2018		9/30/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	07/15/2025	09/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Economy Insurance Company	300315	Agent - Casualty	1/16/2025	2/28/2025
Inactive	American Economy Insurance Company	300315	Agent - Property	1/16/2025	2/28/2025
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	9/6/2018	4/23/2025
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	9/6/2018	4/23/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Property	10/30/2018	4/23/2025
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Casualty	10/30/2018	4/23/2025